YOUR FIRST VISIT

What to Expect:

At your first orthopedic appointment with Dr. Stewart, we will have you fill out a new patient form that will allow us to learn more about your specific symptoms and your general health. Please bring a list of any medications you are currently taking so we can accurately document it in your medical record. When Dr. Stewart comes in to see you, he will have all the necessary information to educate you on your specific diagnosis. Learn more about your first visit with your orthopedic doctor here.

FINDING TREATMENT

Beginning your Journey:

After you have been looked at by one of the orthopedic physician assistants and Dr. Stewart, he will carefully explain your diagnosis, demonstrate any abnormalities on the imaging studies and layout various physical, medical and surgical treatment options for your specific joint condition. We will collaborate with you to create an individualized treatment plan that suits you and your family’s specific needs.

PROCEDURE

The Day of Your Procedure:

You will most likely need to have a driver arranged for at least 24 hours following an orthopedic surgery. When you come in you will need to fill out some paperwork before the procedure. Make sure you read and follow all of the instructions regarding pain medication here. This will allow the healing process to run quickly with little to no complications.

PAIN POINTS

Diseases of the Hip

There are four primary diseases of the hip that may indicate the need for BIRMINGHAM HIP* Resurfacing:

• Osteoporosis
• Rheumatoid Arthritis
• Developmental Dysplasia of the Hip
• Avascular Necrosis

Dr. Stewart will determine whether or not you are a good candidate for the BIRMINGHAM HIP* Resurfacing.

The Procedure

Hip Resurfacing

A total hip replacement surgery requires the removal of the femoral head and the insertion of a hip stem down the shaft of the femur. Hip resurfacing, on the other hand, preserves the femoral head and the femoral neck. During the procedure, Dr. Stewart will only remove a few centimeters of bone around the femoral head, shaping it to fit tightly inside the BIRMINGHAM HIP* Resurfacing implant.

Resurfacing FAQs

• How long will my scar be?
  Dr. Stewart will use an incision of between six and eight inches in length. While some surgeons may use a slightly smaller incision, most will fall in that range.
• What are my physical limitations after surgery?
  Most surgeons will tell you that after the first year, you can return to whatever physical activity you enjoyed before hip pain limited your mobility. For instance, unlike total hip replacement, you will be able to return to jogging or singles tennis after your first year after surgery. During your first year, more conservative, low-impact activities like walking, swimming and bicycling are recommended for strengthening your femoral neck and the muscles around your resurfaced joint.
• Who is a Candidate for Hip Resurfacing?
  Hip resurfacing is intended for young, active adults who are under 60 years of age and in need of a hip replacement. Adults over 60 who are living non-sedentary lifestyles may also be considered for this procedure. However, this can only be further determined by a review of your bone quality.
• How long will the BIRMINGHAM HIP* Resurfacing implant last?
  It is impossible to say how long your implant will last because so many factors play into the lifespan of an implant. In the case of resurfacing, for instance, the metal-on-metal bearing surfaces of your new joint may extend its life longer than that of a traditional total hip replacement, but failure to comply with your physical rehabilitation regime may cause your implant to fail within months. A clinical study showed the BIRMINGHAM HIP* Resurfacing implant had a survivorship of 98.4-percent at the five-year mark, which is comparable with the survivorship of a traditional total hip replacement in the under-60 age group.

Information to Help Assess Risk

Taking factors into consideration when performing joint arthroplasty. 

For any patient that is considering having total joint arthroplasty, we fill out a surgical risk assessment form to evaluate if there are any modifiable risk factors that can be remediated prior to surgery. Smoking is an independent risk factor that makes a patient 5 times more likely to have a perioperative complication from total joint arthroplasty. It is for this reason that we expect all of our patients to quit smoking at least 4-6 weeks prior to surgery to reduce the risk of complications.

Another important risk factor that can increase the chance of having an infection or problems with wound healing is having diabetes that is not well controlled. We have our diabetic patients work closely with their endocrinologist or general medical doctor to adequately control their blood sugars prior to surgery to minimize the risk of developing a surgical complication. We strive to make our diabetic patients have a hemoglobin A1C less then 8 prior to surgery. A fasting blood glucose level will also be checked the morning of surgery and any level >180 would prevent their surgery from proceeding as planned due to the increased risk of developing a complication.

We also encourage our patients to be up to date on their dental work prior to undergoing any total joint arthroplasty. We expect our patients to go in for dental cleanings every 6 months to reduce the risk of developing an infection that could potentially get into the replaced joint. Being up to date on dental work helps to minimize the chance of missing an infected tooth or dental abscess that could potentially allow bacteria to get into the blood stream and then make its way to the newly replaced joint.

If you have further questions regarding our surgical risk abatement process, we’d be happy to discuss it in detail with you at your visit.

Surgical Risk Assessment For Total Joint Arthroplasty